Integrating Technology Adoption Models Into Implementation Science Methodologies: A Mixed-Methods Preimplementation Study

Abstract

Background and Objectives Sustainable implementation of patient-oriented technologies in healthcare settings is challenging. Pre-implementation studies guided by the Consolidated Framework for Implementation Research (CFIR) can provide opportunities to address barriers and leverage facilitators that can maximize the likelihood of successful implementation. When looking to implement patient-oriented technologies, pre-implementation studies may also benefit from guidance from a conceptual framework specific to technology adoption such as the Unified Theory of Acceptance and Use of Technology (UTAUT). This study was, therefore, aimed at identifying determinants for the successful implementation of a patient-oriented technology (i.e., automated pain behavior monitoring [APBM] system) within a healthcare setting (i.e., long-term care [LTC] facility). Research Design and Methods Using a mixed-methods study design, 164 LTC nurses completed a set of questionnaires and 68 LTC staff participated in individual interviews involving their perceptions of an APBM system in LTC environments. Quantitative data were analyzed using a series of mediation analyses and narrative responses were examined using directed content analysis. Results Performance expectancy and effort expectancy partially and fully mediated the influence of implementation, readiness for organizational change, and technology readiness constructs on behavioral intentions to use the APBM system in LTC environments. Findings from the qualitative portion of this study provide guidance for the development of an intervention that is grounded in the CFIR. Discussion and Implications Based on our results, we offer recommendations for the implementation of patient-oriented technologies in healthcare settings.

Implementation of an electronic health record system during global surgical outreach: A prospective evaluation of success and sustainability

“…Implementation science is a research methodology that applies theoretical approaches and frameworks to understand the components of implementation strategies necessary to promote context‐relevant adoption of evidence‐based interventions 13,14 . Utilizing this approach for technology integration has been shown to improve implementation success and sustainability 15,16 . We utilized an effectiveness‐implementation hybrid type 3 design to evaluate implementation success (Table 2).…”

“…13,14 Utilizing this approach for technology integration has been shown to improve implementation success and sustainability. 15,16 We utilized an effectiveness-implementation hybrid type 3 design to evaluate implementation success (Table 2). This approach utilizes primary outcomes based on the success of implementation and secondary outcomes based on the clinical intervention.…”

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study

“…Despite potential for integration of CFIR with the TAM within digital health research [ 37 ], we are unaware of previously published examples. Our approach was to map core components of the Technology Acceptance Model (version 3; TAM-3) [ 38 ] and CFIR frameworks with one another to facilitate application of both in an integrated, parsimonious manner ( Figure 4 ).…”

Domains of contemporary and future ethical dilemmas.

“…The clinical application of computer vision in dementia contexts would necessitate the use of cameras in public areas and private rooms of long-term care facilities. Privacy concerns are often raised by frontline staff about this technology (Gallant et al, in press). Although this computerized approach processes information to notify health care staff when a threshold of pain behaviours is expressed, it is designed to address privacy concerns by not displaying or recording any images.…”